HomeMy WebLinkAboutPermit Electrical 1992-7-10
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SP.IINGt:'IlZ.LU
approval. -" rO~Ulro spoeffie land Use ~
225 FIFTH STREET ". ZO~9- (10 ) ELECTRICAL P"ERlfIT APPLICATION
SPRINGFIELD, OREGON 97477 Dete~ n .y)
INSPECTION REQUEST: 726-37&lbriz<;dSig {A-J. City Job Number '-1A( /{ f5{ 0
OFFICE: 726-3759 nature~
3. COHPLE;'Ir. nr.-SCHEDULE BELOV 4!
1. J4>CA,t[@ OF ;I:NSTALLATION LL .::It c::..
4-\. 0,,"""")':-\ 1\ H\ 0 i\ .ry J .... ) A. New Residential-Single or ~
Multi-Family per dwelling unit. "
Service Included: ~.
Itf()~~fi~O~. n \~
~JOB DE,SCRIPTI9lf ~ OV
-;".)P V\. l' ~ 0 _ ~ . ..l\()"vL I) _
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
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2. CONTRACTOR INSTALLATION ONLY
Electric~l contrac~~ /
Address P.;c~IYP)3 <ih)1 v4CfS
Ci ty 5)0.fN.J Phone'rf ( -()4q/-
Supervisor License Number ~()C1~~
\Q.\.q~
COlQ:D
I ~.l(o .q~.
Expiration Date
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder"
B.
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00
Services or Feeders
Installation, Alterationi or
Relocation:
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
D.
Branch Circuits
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
I
;5D
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Contr. Number
C. " Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
S~uJry of Supervising Electrician
r,/U/J LmdA~\
Owners Name. \ n~ Q t>. ffi \ - ~ 9V
Address ~~5 't'{\t, ; fu
City ~tL.Pho~e~
OVNER ~SfALLATION
The "installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
------------------[Ar7.}-~--------------
DATE: Y') I \O.~ . I
RECEIPT li: ; (. _ _ .8.",H.'t
RECEIVED BY: AJI'!)( 1/ "
.
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
ew, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Add it ional
Circuit or with Service
or Feeder Permi t
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$
2.00
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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